Gout tuaj yeem tsis meej pem nrog lwm tus mob, suav nrog pseudogout, mob caj dab, mob caj dab rheumatoid, thiab mob pob txha. Yog tias koj txhawj xeeb tias koj yuav muaj gout, koj tus kws kho mob yuav tshuaj xyuas koj cov tsos mob thiab cov tsos mob. Nws tseem yuav ua qhov kev kuaj mob txhawm rau txiav txim siab seb koj tus mob puas yog qhov tseeb gout.
Cov kauj ruam
Ntu 1 ntawm 3: Ntsuam Xyuas Cov Cim thiab Cov tsos mob
Kauj Ruam 1. Qhia koj tus kws kho mob txog nws pib li cas
Ib yam uas yuav tsum paub txog yog gout muaj tus yam ntxwv pib. Feem ntau nws pib nrog mob sai, mob hnyav - feem ntau hauv ib leeg, thiab feem ntau yog hauv koj cov ntiv taw loj (ntawm ib sab lossis lwm qhov). Feem ntau nws pib thaum hmo ntuj, thiab tej zaum yuav ua rau koj tsaug zog. Qhov sib koom tes cuam tshuam feem ntau tshwm liab thiab o thiab tuaj yeem sov so rau qhov kov, thiab koj yuav muaj qhov txo qis ntawm cov lus tsa suab nyob ib puag ncig cuam tshuam.
- Yog tias koj qhov mob sib koom ua ke pib zuj zus thiab tsis sib xws nrog cov ntaub ntawv saum toj no, nws yuav tsis tshua muaj mob gout.
- Nws yuav yog lwm yam, xws li mob rheumatoid mob caj dab lossis mob pob txha, ntawm lwm yam.
Kauj Ruam 2. Xav txog tias tej zaum nws yuav yog kab mob sib kis
Ib qho ntawm kev kuaj mob tseem ceeb rau koj tus kws kho mob kom txiav tawm yog qhov muaj peev xwm kis mob sib kis (lossis "mob caj dab septic"), uas yuav muaj kev nthuav qhia zoo ib yam li gout. Kev kis tus kab mob kuj tseem tuaj yeem tshwm sim ib txhij nrog rau kev mob gout, thiab ob qho yuav luag tsis tuaj yeem qhia sib nrug yam tsis muaj kev kuaj mob.
- Ib qho kev sib koom sib kis yuav zoo li yuav tshwm sim sai sai, tshwm liab thiab o tuaj thiab sov so rau ntawm qhov kov, thiab tuaj yeem ua nrog kub cev.
- Koj yuav xav tshuaj xyuas koj cov kua dej sib txawv kom paub qhov txawv ntawm gout thiab kis kab mob.
Kauj Ruam 3. Paub txog qhov muaj peev xwm "pseudogout
Pseudogout, tseem hu ua calcium pyrophosphate deposition (CPPD), kuj nthuav tawm zoo ib yam li gout (yog li nws lub npe).
Kauj Ruam 4. Nco ntsoov seb koj qhov kev sib koom tes daws teeb meem
Kev mob gout mob hnyav yuav tsum daws ntawm nws tus kheej li ntawm peb txog 10 hnub (txawm hais tias kev kho mob yuav pab kom yooj yim cov tsos mob nyob rau lub sijhawm no, txhawm rau ua kom rov zoo dua, thiab tiv thaiv kev mob gout yav tom ntej). Yog tias koj muaj gout, koj yuav ntsib "kev tawm tsam" ntawm nws ua raws los ntawm kev tshem tawm (lossis ua raws li kev daws teeb meem tag nrho). Gout tsis zoo li yog mob hnyav, mob ntev, thiab zoo ib yam. Qhov tseeb, nws ib txwm tuaj raws li kev tawm tsam ib zaug, lossis ua rau muaj kev kub nyhiab thiab ua rau hnyav dua, ua raws lub sijhawm tshem tawm (lossis txhim kho).
Yog tias qhov mob hauv koj qhov sib koom ua ke tau ntau lub lis piam lossis ntau lub hlis, tsis muaj kev hloov pauv ntau, nws yuav yog lwm qhov kev kuaj mob xws li mob rheumatoid mob caj dab lossis mob pob txha
Kauj Ruam 5. Qhia rau koj tus kws kho mob yog tias koj muaj keeb kwm ntawm tus kab mob gout, tsev neeg keeb kwm ntawm kev mob gout, lossis lwm yam kev pheej hmoo ntawm gout
Tsis tas yuav hais, yog tias koj tau muaj mob gout yav dhau los, koj muaj feem yuav muaj tus mob rov tshwm sim ntau dua; yog li ntawd, yog tias koj muaj keeb kwm yav dhau los ntawm kev mob gout, koj qhov xwm txheej tam sim no muaj feem ntau yuav ua rau mob gout ib yam (tsis yog ua qhov kev kuaj mob tshiab tag nrho cuam tshuam rau koj kev sib koom tes).
- Yog tias koj cov neeg hauv koj tsev neeg tau muaj mob gout ua ntej, koj kuj tseem muaj kev pheej hmoo loj ntawm kev tsim gout. Qhov no, ntxiv, yuav nce qhov tshwm sim uas koj qhov teeb meem sib koom tam sim no yog mob ntsig txog.
- Lwm qhov kev pheej hmoo ntxiv rau kev mob gout suav nrog: ua txiv neej, ua poj niam tom qab cev xeeb tub, muaj lwm yam mob (xws li ntshav siab, ntshav qab zib, lossis teeb meem lub raum), haus cawv ntau dhau, rog dhau, thiab noj qee yam tshuaj (xws li tshuaj aspirin, diuretics, thiab qee yam tshuaj tiv thaiv kab mob).
Kauj Ruam 6. Tshawb xyuas seb puas muaj tophi
Ntxiv rau qhov mob hnyav (luv luv) gout tawm tsam, kuj tseem muaj cov neeg uas raug kev txom nyem los ntawm gout ntev. Gout ntev muaj cov kab mob gout rov tshwm sim nyob rau lub sijhawm ntev. Nws feem ntau ua rau tsim "tophi" (tawv pob hauv qab daim tawv nqaij hauv thaj chaw sib koom ua ke), uas yog tus yam ntxwv ntawm tus mob gout ntev.
- Lub xub ntiag ntawm tophi - uas tuaj yeem pom kev pom hauv kev sib koom ua ke - yog ib qho ntawm cov cim qhia txog mob gout ntev (tseem hu ua "tophaceous gout").
- Qhov no yog ib txoj hauv kev zoo tshaj plaws kom paub qhov txawv ntawm gout los ntawm lwm yam kev mob caj dab, xws li mob caj dab rheumatoid, vim tias tsis muaj lwm yam kev mob caj dab ntev nrog tophi.
Kauj Ruam 7. Saib cov naj npawb ntawm cov pob qij txha koom nrog
Cov xwm txheej kev noj qab haus huv los txiav txim siab hauv qhov kev kuaj mob sib txawv yuav vam khom rau seb koj puas muaj ib leeg cuam tshuam, lossis cuam tshuam ntau pob qij txha. Qhov sib txawv yog raws li hauv qab no:
- Yog tias koj tsuas muaj ib qho cuam tshuam, nws yuav muaj feem ntau yog mob gout, pseudogout, lossis kis mob sib koom.
- Yog tias koj muaj ntau yam pob qij txha cuam tshuam, nws tseem tuaj yeem mob gout lossis pseudogout. Nws kuj tseem yuav yog lwm yam mob, txawm li cas los xij, xws li mob rheumatoid mob caj dab lossis mob pob txha.
- Thaum kawg, yog tias koj muaj ntau yam pob qij txha cuam tshuam, qhov tshwm sim ntawm kev kis tus kab mob yog ib qho me me (tsis yog ib qho kev kis kab mob feem ntau cuam tshuam rau ib leeg sib koom ua ke).
Ntu 2 ntawm 3: Tshawb Nrhiav Ntxiv
Kauj Ruam 1. Mus kuaj ntshav
Kev kuaj ntshav tuaj yeem ntsuas qib uric acid thiab creatinine hauv koj cov ntshav. Ua kom cov qib uric acid ntau ntxiv tuaj yeem ua rau nws yog gout. Creatinine yog ntsuas kev ua haujlwm ntawm lub raum. Kev ua haujlwm tsis zoo ntawm lub raum yuav ua rau uric acid tshem tawm tsis zoo los ntawm koj lub cev, thiab qhov ua kom muaj cov uric acid tuaj yeem ua rau koj mob gout.
- Nco tseg, txawm li cas los xij, tsis muaj qhov cuam tshuam ncaj qha ntawm qib uric acid ntawm koj cov kev kuaj ntshav thiab kuaj mob gout.
- Coob leej neeg tau nce qib uric acid, tab sis tsis tau pom dua cov tsos mob lossis cov tsos mob ntawm gout.
- Ib yam li ntawd, ntau tus tib neeg uas muaj cov tsos mob qhia pom thiab tsos mob ntawm gout tsis yog tus uas nce qib ntawm cov kua qaub.
- Muaj kev sib txheeb, kom paub tseeb, thiab koj yuav muaj feem yuav mob gout tau nce nrog qib uric acid ntau ntxiv, tab sis nws tsis tas yuav tsum tau (tsis yog nws yog cov yam tshwj xeeb) hauv kev kuaj mob gout.
Kauj Ruam 2. Tau txais cov kua dej hauv qhov cuam tshuam ua ke
Koj tus kws kho mob yuav siv rab koob "nqus", lossis tshem tawm, qee cov kua dej los ntawm koj qhov kev cuam tshuam. Tom qab ntawd nws yuav tshuaj xyuas cov kua dej no hauv lub tsom iav.
- Yog tias nws yog gout, lub tsom iav yuav qhia pom tias muaj cov kua uric acid muaju.
- Nws yog pseudogout, lub tshuab tsom me me yuav qhia pom tias muaj cov calcium pyrophosphate muaju.
- Yog tias nws yog mob caj pas, lub tshuab kuaj kab mob yuav qhia tsis tau uric acid crystals lossis calcium pyrophosphate crystals.
Kauj Ruam 3. Kom cov kua dej nqus tau xa mus rau kab lis kev cai
Txawm hais tias saib synovial sib koom ua kua hauv lub tshuab kuaj kab mob tuaj yeem kuaj mob ntawm tus kab mob gout (yog tias pom muaj cov kua qaub uric acid pom), nws yog qhov tseem ceeb kom nkag siab tias gout thiab kab mob sib kis tsis tas yuav tsum yog ob leeg tshwj xeeb. Yog li ntawd, txawm hais tias qhov kev ntsuam xyuas rov qab kuaj mob rau tus kab mob gout, kev kis kab mob tseem tuaj yeem tshwm sim.
- Muaj cov kua synovial xa mus rau kab lis kev cai yuav tshuaj xyuas seb puas muaj kab mob lossis lwm yam kab mob loj tuaj.
- Yog tias muaj kev kis tus kab mob, cov zaub mov kab lis kev cai yuav loj hlob cov kab mob me me, uas yuav kuaj mob rau "mob caj dab septic" (kev kuaj mob uas yuav muaj nyob nrog rau gout).
Kauj Ruam 4. Nug koj tus kws kho mob kom xoo hluav taws xob ntawm cov leeg uas cuam tshuam
Kev xoo hluav taws xob tuaj yeem pab kom paub qhov txawv ntawm gout thiab lwm yam kev mob caj dab xws li mob caj dab rheumatoid, uas muaj qhov txawv txav ntawm x-ray. Xoo hluav taws xob feem ntau yog txaus rau kev yees duab; Txawm li cas los xij, qee zaum, kuaj ultrasound lossis CT scan kuj tseem tuaj yeem pab ntsuas koj qhov teeb meem sib koom, tshwj xeeb yog tias nws tsis tshwm sim los ntawm gout.
Ntu 3 ntawm 3: Kho Gout
Kauj Ruam 1. Siv NSAIDs los kho cov tsos mob thiab txo qhov mob o
Yog tias koj tau kuaj pom tus kab mob gout, koj tus kws kho mob yuav qhia koj kom pib noj cov tshuaj tsis-tshuaj tiv thaiv kab mob (NSAIDs). Piv txwv suav nrog Ibuprofen (Advil, Motrin) thiab Naproxen (Aleve). Cov no tuaj yeem yuav tom khw ntawm koj lub tsev muag tshuaj lossis khw muag tshuaj.
Muaj zog NSAIDs tuaj yeem muab rau koj los ntawm koj tus kws kho mob yog tias cov ntawv tom khw tsis txaus los pab daws koj tus mob gout
Kauj Ruam 2. Sim Colchicine
Colchicine yog cov tshuaj uas muaj txiaj ntsig zoo ntawm kev txo qhov mob los ntawm gout; txawm li cas los xij, thaum noj tshuaj ntau (uas feem ntau yuav tsum tau txhawm rau tawm tsam mob gout), cov kev mob tshwm sim ntawm xeev siab, ntuav, thiab/lossis raws plab feem ntau ntau dhau los lis.
- Raws li qhov tshwm sim, colchicine feem ntau siv tom qab mob gout nres, nrog lub hom phiaj ntawm kev tiv thaiv kev mob gout yav tom ntej.
- Kev noj tshuaj tsawg rau kev tiv thaiv lub hom phiaj, cov kev mob tshwm sim ntawm colchicine tsis tshua muaj teeb meem.
Kauj Ruam 3. Xaiv corticosteroids
Corticosteroids yog ib txoj hauv kev tswj kev mob (thiab kho qhov mob tom qab) rau cov uas tsis tuaj yeem tiv taus NSAIDs thiab/lossis Colchicine. Corticosteroids tuaj yeem muab tshuaj rau hauv cov ntsiav tshuaj, lossis lawv tuaj yeem txhaj ncaj qha rau hauv qhov cuam tshuam (uas feem ntau yog qhov kev xaiv zoo dua, vim tias koj zam kev phiv uas tuaj yeem los ntawm kev noj lawv hauv daim ntawv tshuaj).
- Piv txwv ntawm corticosteroid yog Prednisone.
- Corticosteroids feem ntau muab rau hauv qhov txwv, xws li txhaj ib qho (lossis tsawg) rau hauv koj qhov kev cuam tshuam, thiab/lossis txwv tsis pub siv cov tshuaj corticosteroids hauv cov ntsiav tshuaj.
Kauj Ruam 4. Siv tshuaj los tiv thaiv kev mob gout yav tom ntej
Ntxiv rau kev kho tus mob gout mob hnyav (lossis gout exacerbation, yog tias koj raug kev txom nyem los ntawm gout ntev), koj tus kws kho mob yuav muab tshuaj rau koj tiv thaiv. Lub hom phiaj ntawm cov tshuaj no yog txhawm rau txo koj txoj kev yuav raug mob gout yav tom ntej.
- Allopurinol yog ib qho piv txwv ntawm cov tshuaj uas tuaj yeem pab tiv thaiv kev tsim cov kua qaub ntau dhau.
- Probenecid yog ib qho piv txwv ntawm cov tshuaj uas tuaj yeem pab koj lub raum lub peev xwm lim thiab tshem cov kua qaub hauv koj lub cev.
